Progesterone And Immunological Changes In Human Immunodeficiency Virus Infection During Pregnancy

Abstract

Immune responses during pregnancy are specifically regulated to allow fight against infections and prevent any damage to the growing fetus. HIV infections, a pro-inflammatory infection, present a challenge to the enhancement of pregnancy specific immuno-modulation of pro-inflammatory immunity. HIV Infection during pregnancy remains a health concern in regard to immune response and status. The immunological outcome of HIVinfected pregnant mothers and their effect on the health status and pregnancy outcome are areas of paramount importance in public health. In the current article, we review current data about the characteristic progesterone and immune responses in conjoint cases of HIV infection and pregnancy and present an immunological hypothesis to explain the findings. In conclusion HIV infection in pregnant women is associated with lower progesterone and increased cellular immunity compared to HIV-non-infected women. There is a clear indication that HIV infection may cause lower levels of progesterone among the HIV-infected pregnant women compared to the HIV-non- infected women. Most of the highlighted studies have indicated that HIV-infection during pregnancy is characterized by an elevation of both inflammatory and regulatory immune responses in response to both HIV infection and pregnancy concurrently. The reviewed studies have shown varied results regarding the lymphocyte counts during pregnancy and HIV infections. It, therefore, remains unclear how HIV infection would affect lymphocytes counts as pregnancy advances considering all arms of the immune response in a single study. Further researches are thus required to address the mechanism of interaction of the two opposing immune responses; pro-inflammatory (Th1) response as a result of HIV infection and the immune regulation (Th2) response during pregnancy that can define the delicate balance of immune response in conjoint cases of HIV infection and pregnancy. Further research is required to address the mechanism of interaction of the two opposing immune responses against HIV infection and the immune regulation during pregnancy that defines the altered immune response.